Open Access Publicationshttp://hdl.handle.net/10294/3404
Open Access Working Group in the Dr. John Archer LibrarySun, 02 Aug 2015 22:27:28 GMT2015-08-02T22:27:28ZProfessional Regulation: A Potentially Valuable Tool in Responding to ‘‘Stem Cell Tourism’’http://hdl.handle.net/10294/5502
Professional Regulation: A Potentially Valuable Tool in Responding to ‘‘Stem Cell Tourism’’
Zarzeczny, Amy; Caulfield, Timothy; Ogbogu, Ubaka; Bell, Peter; Crooks, Valorie A.; Kamenova, Kalina; Master, Zubin; Rachul, Christen; Snyder, Jeremy; Toews, Maeghan; Zoeller, Sonja
The growing international market for unproven stem cell-based
interventions advertised on a direct-to-consumer basis over the
internet (‘‘stem cell tourism’’) is a source of concern because of
the risks it presents to patients as well as their supporters, domestic
health care systems, and the stem cell research field. Emerging responses
such as public and health provider-focused education and
national regulatory efforts are encouraging, but the market continues
to grow. Physicians play a number of roles in the stem cell
tourism market and, in many jurisdictions, are members of a regulated
profession. In this article, we consider the use of professional
regulation to address physician involvement in stem cell tourism.
Although it is not without its limitations, professional regulation is
a potentially valuable tool that can be employed in response to
problematic types of physician involvement in the stem cell
tourism market.
Tue, 09 Sep 2014 00:00:00 GMThttp://hdl.handle.net/10294/55022014-09-09T00:00:00ZUnproven stem cell-based interventions & physicians’ professional obligations; a qualitative study with medical regulatory authorities in Canadahttp://hdl.handle.net/10294/5501
Unproven stem cell-based interventions & physicians’ professional obligations; a qualitative study with medical regulatory authorities in Canada
Zarzeczny, Amy; Clark, Marianne
Background - The pursuit of unproven stem cell-based interventions (“stem cell tourism”) is an emerging issue that raises various concerns. Physicians play different roles in this market, many of which engage their legal, ethical and professional obligations. In Canada, physicians are members of a self-regulated profession and their professional regulatory bodies are responsible for regulating the practice of medicine and protecting the public interest. They also provide policy guidance to their members and discipline members for unprofessional conduct.
Methods - We conducted semi-structured telephone interviews with representatives from six different provincial Colleges of Physicians and Surgeons in Canada to discuss their experiences and perspectives regarding stem cell tourism. Our focus was on exploring how different types of physician involvement in this market would be viewed by physicians’ professional regulatory bodies in Canada.
Results - When considering physicians’ professional obligations, participants drew analogies between stem cell tourism and other areas of medical tourism as well as with some aspects of complementary alternative medicine where existing policies, codes of ethics and regulations provide some guidance. Canadian physicians are required to act in the best interests of their patients, respect patient autonomy, avoid conflicts of interest and pursue evidence-based practice in accordance with accepted standards of care. Physicians who provide unproven treatments falling outside the standard of care, not in the context of an approved research protocol, could be subject to professional discipline. Other types of problematic conduct include referrals involving financial conflict of interest and failure to provide urgent medically necessary care. Areas of ambiguity include physicians’ obligations when asked for information and advice about seeking unproven medical treatments, in terms of providing non-urgent follow-up care, and when asked to support efforts to go abroad by providing tests or procedures in advance that would not otherwise be medically indicated.
Conclusions - Specific policy guidance regarding the identified areas of tension or ambiguity may prove helpful for physicians struggling with these issues. Further consideration of the complex interplay of factors at issue in how physicians may (should) respond to patient demands related to unproven medical interventions while meeting their professional, legal and ethical obligations, is warranted.
Wed, 01 Oct 2014 00:00:00 GMThttp://hdl.handle.net/10294/55012014-10-01T00:00:00ZIdentification of a Pantoea Biosynthetic Cluster That Directs the Synthesis of an Antimicrobial Natural Producthttp://hdl.handle.net/10294/5380
Identification of a Pantoea Biosynthetic Cluster That Directs the Synthesis of an Antimicrobial Natural Product
Stavrinides, John; Smith, Derek D. N.; Walterson, Alyssa M.
Fire Blight is a destructive disease of apple and pear caused by the enteric bacterial pathogen, Erwinia amylovora. E. amylovora initiates infection by colonizing the stigmata of apple and pear trees, and entering the plants through natural openings. Epiphytic populations of the related enteric bacterium, Pantoea, reduce the incidence of disease through competition and antibiotic production. In this study, we identify an antibiotic from Pantoea ananatis BRT175, which is effective against E. amylovora and select species of Pantoea. We used transposon mutagenesis to create a mutant library, screened approximately 5,000 mutants for loss of antibiotic production, and recovered 29 mutants. Sequencing of the transposon insertion sites of these mutants revealed multiple independent disruptions of an 8.2 kb cluster consisting of seven genes, which appear to be coregulated. An analysis of the distribution of this cluster revealed that it was not present in any other of our 115 Pantoea isolates, or in any of the fully sequenced Pantoea genomes, and is most closely related to antibiotic biosynthetic clusters found in three different species of Pseudomonas. This identification of this biosynthetic cluster highlights the diversity of natural products produced by Pantoea.
Thu, 15 May 2014 00:00:00 GMThttp://hdl.handle.net/10294/53802014-05-15T00:00:00ZIs All Bullying the Same?http://hdl.handle.net/10294/5379
Is All Bullying the Same?
Zhang, Lihui; Osberg, Lars; Phipps, Shelley
We ask whether verbal abuse, threats of violence and physical assault among Canadian youth have
the same determinants and whether these determinants are the same for boys and girls. If these are different, the
catch-all term “bullying” may mis-specify analysis of what are really different types of behavior
Wed, 01 Jan 2014 00:00:00 GMThttp://hdl.handle.net/10294/53792014-01-01T00:00:00Z